Coronavirus prep

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  • lynn_glenmont
    lynn_glenmont Posts: 10,097 Member
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    On the related subject of people claiming that HIPAA and the ADA give them the right to not wear a mask if they claim a disability, with such individuals often claiming it is illegal to even ask what the disability is.

    The ADA has issued a statement which says that a business can indeed ask what the disability is for the purpose of making reasonable accommodations (for example, someone with a breathing issue would need different accommodations from someone who gets panic attacks when their face is covered or someone who needs to see lips to sight-read) and that in any case “reasonable accommodations” doesn’t mean you get to not wear a mask. An example of reasonable accommodations might include curb-side pickup, or having someone shop for you, or wearing a face shield instead of a mask. It never means the disabled person just gets to ignore the rule and endanger others.

    Unless you're talking about the American Dental Association, the ADA is a piece of legislation (the Americans with Disabilities Act), and I don't understand how a piece of legislation can issue a statement.
  • lynn_glenmont
    lynn_glenmont Posts: 10,097 Member
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?
  • TonyB0588
    TonyB0588 Posts: 9,520 Member
    kshama2001 wrote: »
    ythannah wrote: »

    The shortages are not due to people buying wipes entirely, the material used is also used for PPE - so there is a manufacturing shortage.

    Ah, that makes sense. Everything else is in pretty much normal supply here [Canada] except wipes. I've always preferred them for quick small clean-ups because of the dogs, as I once had a puppy decide to lick a disinfectant I'd sprayed before I had a chance to wipe it up and I never want one of my animals to ingest a toxic substance again. Anyway, I had a few tubs on hand and I've been rationing them since I haven't been able to replace them since March.

    My father doesn't like colas and drinks only diet pop, and I've been unable to find anything other than diet Coke or Pepsi for about the past month. Turns out there is also a shortage of both artificial sweeteners and aluminum for cans so manufacturers have been focusing on producing their most popular flavours. So now my poor father not only doesn't leave the house, he doesn't have pop to drink.

    We assumed this was why my OH's caffeine-free Coke had disappeared - thanks for confirming :)

    Ah, now it all makes sense.

    Now, who are you MONSTERS who are not adequately supporting Cherry Coke Zero, clearly the superior cola choice?

    That's not Coke!!

    i1z2awp553ke.jpg

    This is what you need.
  • AnnPT77
    AnnPT77 Posts: 34,598 Member
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    Public, large. Shifting to round numbers, say 10,000 regular employees (faculty, administrative) over the course of a year, around 10,000 or so student employees at any given time, twice that over the course of a year. The insurance pool would've been mostly the full-time regulars (plus spouses/dependents), so well more than 10K people there, plus an unknown-to-me number of retirees (full insurance for a lot of those under 65 (and families), at that time, just like if they were still employed, though they don't offer that deal to newer hires anymore) and medicare supplemental for those retirees over 65 (and surviving spouses).

    It would be a mix of white collar and blue collar (big food service organization, groundskeepers for giant campus, custodial staff for a couple of hundred buildings, skilled trades of many types), police, professionals (doctors, lawyers, pharmacists), etc. That's a decent-ish population to average over.

    I don't know if there was a layer of catastophic risk insurance somewhere in the mix, but I never heard of it. (It was a big enough place that it would self-insure for quite large risks, and externally insure only the excess, in some categories. There was an Office of Risk Management to deal with that and a bunch of other stuff - like avoidance of risk in the first place.)

    I don't know whether all this stuff is the same now, or not. I've been retired for quite a while now.
  • Theoldguy1
    Theoldguy1 Posts: 2,496 Member
    edited August 2020
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    My company is self insured (with a 3rd party to administer claims). With 45k US employees by the time you add in dependents and retirees covered there are easily 150k people+ in the insurance pool. We have another 60k employees worldwide which would also have self funded company insurance but there would be some interplay with governmental insurance programs so don't have a clear picture of that liability. Enough that statistical abnormalities won't move anything. As @AnnPT77 mentioned there may be some sort of umbrella type policy carried but never heard of it.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    Theoldguy1 wrote: »
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    My company is self insured (with a 3rd party to administer claims). With 45k US employees by the time you add in dependents and retirees covered there are easily 150k people+ in the insurance pool. We have another 60k employees worldwide which would also have self funded company insurance but there would be some interplay with governmental insurance programs so don't have a clear picture of that liability. Enough that statistical abnormalities won't move anything. As @AnnPT77 mentioned there may be some sort of umbrella type policy carried but never heard of it.

    Mine is self-insured also with a 3rd party administrator and we only have around 10K U.S. employees.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    On the related subject of people claiming that HIPAA and the ADA give them the right to not wear a mask if they claim a disability, with such individuals often claiming it is illegal to even ask what the disability is.

    The ADA has issued a statement which says that a business can indeed ask what the disability is for the purpose of making reasonable accommodations (for example, someone with a breathing issue would need different accommodations from someone who gets panic attacks when their face is covered or someone who needs to see lips to sight-read) and that in any case “reasonable accommodations” doesn’t mean you get to not wear a mask. An example of reasonable accommodations might include curb-side pickup, or having someone shop for you, or wearing a face shield instead of a mask. It never means the disabled person just gets to ignore the rule and endanger others.

    Unless you're talking about the American Dental Association, the ADA is a piece of legislation (the Americans with Disabilities Act), and I don't understand how a piece of legislation can issue a statement.

    Perhaps the EEOC.
  • missysippy930
    missysippy930 Posts: 2,577 Member
    TonyB0588 wrote: »
    Had a COVID19 reality this week.

    My wife had a medical procedure today. Preparation in the preceding days involved having a COVID19 test - no one can enter our hospitals without being tested first. I went with her, but watched from outside the door. She enjoyed that, and the doctor said she got an A+ for the way she took that thing in her nose and her throat.

    At the hospital today, no one allowed inside apart from the patient. She's been there before and I'd usually go with her to the room and through all the preparations until she's actually wheeled into the operating theater. Not so with COVID19 around. So they quite nicely asked me to go home and wait for a call. On my return they pushed her out to the car, instead of me going in to bring her out like previous times.

    Certainly the "new normal".

    I hate the new normal for stuff like this - I had a routine procedure done 2 weeks ago and I missed having my husband by my side...

    My heart goes out to you ❤️It’s a very difficult situation, but, needed to protect staff, and patients, from unnecessary spread of the virus to vulnerable people that are in the hospital. If everyone did their part, (social distancing, face coverings, good hand washing and coughing into elbow) lives will be saved. It’s fact that countries that are handling Covid better than the US is handling it, are faring much better. Over 180,000 dead in 6 months. It’s very sad to think of people having to go through hospital stays and procedures alone, but a small price to pay for knowing it may be preventing you, or another person, and their loved ones from having to go through this. During this crisis, people in the health care profession, have been the most courageous, sacrificing people on the planet. We can show appreciation to them by following the safety guidelines and cutting down on the spread of the virus, and possibly making their jobs a little easier.
  • GaleHawkins
    GaleHawkins Posts: 8,159 Member
    TonyB0588 wrote: »
    Had a COVID19 reality this week.

    My wife had a medical procedure today. Preparation in the preceding days involved having a COVID19 test - no one can enter our hospitals without being tested first. I went with her, but watched from outside the door. She enjoyed that, and the doctor said she got an A+ for the way she took that thing in her nose and her throat.

    At the hospital today, no one allowed inside apart from the patient. She's been there before and I'd usually go with her to the room and through all the preparations until she's actually wheeled into the operating theater. Not so with COVID19 around. So they quite nicely asked me to go home and wait for a call. On my return they pushed her out to the car, instead of me going in to bring her out like previous times.

    Certainly the "new normal".

    I hate the new normal for stuff like this - I had a routine procedure done 2 weeks ago and I missed having my husband by my side...

    My heart goes out to you ❤️It’s a very difficult situation, but, needed to protect staff, and patients, from unnecessary spread of the virus to vulnerable people that are in the hospital. If everyone did their part, (social distancing, face coverings, good hand washing and coughing into elbow) lives will be saved. It’s fact that countries that are handling Covid better than the US is handling it, are faring much better. Over 180,000 dead in 6 months. It’s very sad to think of people having to go through hospital stays and procedures alone, but a small price to pay for knowing it may be preventing you, or another person, and their loved ones from having to go through this. During this crisis, people in the health care profession, have been the most courageous, sacrificing people on the planet. We can show appreciation to them by following the safety guidelines and cutting down on the spread of the virus, and possibly making their jobs a little easier.

    Not sure why we didn’t realize this before, but we just realized drs can’t get their teeth cleaned (or checked, since he’s having pain), or do much of anything when they require you to sign that you haven’t been in contact w someone who’s tested positive. Well, my dr friend sometimes treats patients w Covid, so he has to answer yes. He’s in full PPE, so not a casual contact, and his chances of getting it through N95 + cloth mask + face shield + gloves + gown + booties is not comparable to the person who spent lots of unmasked time w a Positive coworker or family member, but the form (and the office) doesn’t distinguish. So until Covid is gone or we get a vaccine, I hope the poor guy doesn’t need a root canal

    https://google.com/search?q=DenTek+Professional+Oral+Care+Kit&rlz=1C1CHFX_enUS611US612&oq=DenTek+Professional+Oral+Care+Kit&aqs=chrome..69i57j69i61&sourceid=chrome&ie=UTF-8

    I find this $6 option at WalMart works quite well for cleaning my teeth at home.
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    This is exactly why companies that run their own insurance aren’t nearly as common as they used to be. My father was a VP at a metal building company which provided its own health insurance, and a single person, the wife of a worker, got AIDS from a blood transfusion early in the AIDS crisis. Her medical bills were in the millions, and the company paid them, but decided they couldn’t keep doing that and started buying insurance.
  • lynn_glenmont
    lynn_glenmont Posts: 10,097 Member
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    Public, large. Shifting to round numbers, say 10,000 regular employees (faculty, administrative) over the course of a year, around 10,000 or so student employees at any given time, twice that over the course of a year. The insurance pool would've been mostly the full-time regulars (plus spouses/dependents), so well more than 10K people there, plus an unknown-to-me number of retirees (full insurance for a lot of those under 65 (and families), at that time, just like if they were still employed, though they don't offer that deal to newer hires anymore) and medicare supplemental for those retirees over 65 (and surviving spouses).

    It would be a mix of white collar and blue collar (big food service organization, groundskeepers for giant campus, custodial staff for a couple of hundred buildings, skilled trades of many types), police, professionals (doctors, lawyers, pharmacists), etc. That's a decent-ish population to average over.

    I don't know if there was a layer of catastophic risk insurance somewhere in the mix, but I never heard of it. (It was a big enough place that it would self-insure for quite large risks, and externally insure only the excess, in some categories. There was an Office of Risk Management to deal with that and a bunch of other stuff - like avoidance of risk in the first place.)

    I don't know whether all this stuff is the same now, or not. I've been retired for quite a while now.

    Interesting. I worked for two different public universities (one medium to large and one extremely large) as a student employee (undergrad and grad) and don't remember getting insurance as an employee. Of course, it was many decades ago, and both were part-time jobs. Much different landscape these days, I'm sure (or I hope).
  • lynn_glenmont
    lynn_glenmont Posts: 10,097 Member
    Theoldguy1 wrote: »
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    My company is self insured (with a 3rd party to administer claims). With 45k US employees by the time you add in dependents and retirees covered there are easily 150k people+ in the insurance pool. We have another 60k employees worldwide which would also have self funded company insurance but there would be some interplay with governmental insurance programs so don't have a clear picture of that liability. Enough that statistical abnormalities won't move anything. As @AnnPT77 mentioned there may be some sort of umbrella type policy carried but never heard of it.

    Mine is self-insured also with a 3rd party administrator and we only have around 10K U.S. employees.

    Wow. Apparently a lot more of this than I was aware of, other than as a theoretical situation and occasionally in news stories about small companies that found regular employer insurance plans prohibitively expensive.
  • lynn_glenmont
    lynn_glenmont Posts: 10,097 Member
    TonyB0588 wrote: »
    Had a COVID19 reality this week.

    My wife had a medical procedure today. Preparation in the preceding days involved having a COVID19 test - no one can enter our hospitals without being tested first. I went with her, but watched from outside the door. She enjoyed that, and the doctor said she got an A+ for the way she took that thing in her nose and her throat.

    At the hospital today, no one allowed inside apart from the patient. She's been there before and I'd usually go with her to the room and through all the preparations until she's actually wheeled into the operating theater. Not so with COVID19 around. So they quite nicely asked me to go home and wait for a call. On my return they pushed her out to the car, instead of me going in to bring her out like previous times.

    Certainly the "new normal".

    I hate the new normal for stuff like this - I had a routine procedure done 2 weeks ago and I missed having my husband by my side...

    My heart goes out to you ❤️It’s a very difficult situation, but, needed to protect staff, and patients, from unnecessary spread of the virus to vulnerable people that are in the hospital. If everyone did their part, (social distancing, face coverings, good hand washing and coughing into elbow) lives will be saved. It’s fact that countries that are handling Covid better than the US is handling it, are faring much better. Over 180,000 dead in 6 months. It’s very sad to think of people having to go through hospital stays and procedures alone, but a small price to pay for knowing it may be preventing you, or another person, and their loved ones from having to go through this. During this crisis, people in the health care profession, have been the most courageous, sacrificing people on the planet. We can show appreciation to them by following the safety guidelines and cutting down on the spread of the virus, and possibly making their jobs a little easier.

    Not sure why we didn’t realize this before, but we just realized drs can’t get their teeth cleaned (or checked, since he’s having pain), or do much of anything when they require you to sign that you haven’t been in contact w someone who’s tested positive. Well, my dr friend sometimes treats patients w Covid, so he has to answer yes. He’s in full PPE, so not a casual contact, and his chances of getting it through N95 + cloth mask + face shield + gloves + gown + booties is not comparable to the person who spent lots of unmasked time w a Positive coworker or family member, but the form (and the office) doesn’t distinguish. So until Covid is gone or we get a vaccine, I hope the poor guy doesn’t need a root canal

    That's a shame. I expect your doctor friend knows more about alternative pathways for medical treatment than I do, but maybe he could try contacting a specialist (dental surgeon) or a dental school, to see if they might have more nuanced procedures for assessing risk and accepting patients? I knew someone many years ago who used to get her dental exams and treatments either free or very much discounted by going to a dental school and letting the students work on her. I think both the savings and filling the need for dental students to have patients were a draw for her.
  • AnnPT77
    AnnPT77 Posts: 34,598 Member
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    Public, large. Shifting to round numbers, say 10,000 regular employees (faculty, administrative) over the course of a year, around 10,000 or so student employees at any given time, twice that over the course of a year. The insurance pool would've been mostly the full-time regulars (plus spouses/dependents), so well more than 10K people there, plus an unknown-to-me number of retirees (full insurance for a lot of those under 65 (and families), at that time, just like if they were still employed, though they don't offer that deal to newer hires anymore) and medicare supplemental for those retirees over 65 (and surviving spouses).

    It would be a mix of white collar and blue collar (big food service organization, groundskeepers for giant campus, custodial staff for a couple of hundred buildings, skilled trades of many types), police, professionals (doctors, lawyers, pharmacists), etc. That's a decent-ish population to average over.

    I don't know if there was a layer of catastophic risk insurance somewhere in the mix, but I never heard of it. (It was a big enough place that it would self-insure for quite large risks, and externally insure only the excess, in some categories. There was an Office of Risk Management to deal with that and a bunch of other stuff - like avoidance of risk in the first place.)

    I don't know whether all this stuff is the same now, or not. I've been retired for quite a while now.

    Interesting. I worked for two different public universities (one medium to large and one extremely large) as a student employee (undergrad and grad) and don't remember getting insurance as an employee. Of course, it was many decades ago, and both were part-time jobs. Much different landscape these days, I'm sure (or I hope).

    Maybe I wasn't clear. The part-time student employees didn't get insurance. Relatively late in my employment there, the graduate assistants unionized and did get a form of health insurance (different plans than the regular employees, so I'm not sure whether that was a self-insured plan, or not). The university self-insured for regular employees (and their dependents), and I believe the same for the retirees under 65 since they were literally the same plans. I suspect they self-insured for the medicare supplemental retirees, too, but I don't know that piece for certain. I retired in 2006.
  • lynn_glenmont
    lynn_glenmont Posts: 10,097 Member
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    AnnPT77 wrote: »
    I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

    Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

    I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
    https://privacyruleandresearch.nih.gov/pr_06.asp

    I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

    I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

    For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

    I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

    I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

    Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly". :smile:

    FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

    In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

    The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

    I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

    Public, large. Shifting to round numbers, say 10,000 regular employees (faculty, administrative) over the course of a year, around 10,000 or so student employees at any given time, twice that over the course of a year. The insurance pool would've been mostly the full-time regulars (plus spouses/dependents), so well more than 10K people there, plus an unknown-to-me number of retirees (full insurance for a lot of those under 65 (and families), at that time, just like if they were still employed, though they don't offer that deal to newer hires anymore) and medicare supplemental for those retirees over 65 (and surviving spouses).

    It would be a mix of white collar and blue collar (big food service organization, groundskeepers for giant campus, custodial staff for a couple of hundred buildings, skilled trades of many types), police, professionals (doctors, lawyers, pharmacists), etc. That's a decent-ish population to average over.

    I don't know if there was a layer of catastophic risk insurance somewhere in the mix, but I never heard of it. (It was a big enough place that it would self-insure for quite large risks, and externally insure only the excess, in some categories. There was an Office of Risk Management to deal with that and a bunch of other stuff - like avoidance of risk in the first place.)

    I don't know whether all this stuff is the same now, or not. I've been retired for quite a while now.

    Interesting. I worked for two different public universities (one medium to large and one extremely large) as a student employee (undergrad and grad) and don't remember getting insurance as an employee. Of course, it was many decades ago, and both were part-time jobs. Much different landscape these days, I'm sure (or I hope).

    Maybe I wasn't clear. The part-time student employees didn't get insurance. Relatively late in my employment there, the graduate assistants unionized and did get a form of health insurance (different plans than the regular employees, so I'm not sure whether that was a self-insured plan, or not). The university self-insured for regular employees (and their dependents), and I believe the same for the retirees under 65 since they were literally the same plans. I suspect they self-insured for the medicare supplemental retirees, too, but I don't know that piece for certain. I retired in 2006.

    No, I didn't assume you were saying that part-time student employees had insurance. I was just putting my ancient experience in its (probably irrelevant) context -- that I wasn't full-time. Well, come to think of it, as an undergrad I was "full-time" in some summers, and I worked full-time during most of the academic year following graduation, but in both cases the full-time hours were planned as temporary situations with known end-dates, so I imagine it came under an exception for treating me as a regular full-time employee. I must have been paid out of a contract/grant for the work after graduation, given the work I was doing, so that may have had its own set of rules.

    I was young and unconcerned about my rights, in any case. Just happy to have the hours at a better-than-minimum-wage rate doing work that had a lot of variety and where I often got to learn new things.

    Thanks for inspiring a trip down memory lane. I'm smiling remembering those days and all the people I haven't seen in years.
  • TonyB0588
    TonyB0588 Posts: 9,520 Member
    TonyB0588 wrote: »
    Had a COVID19 reality this week.

    My wife had a medical procedure today. Preparation in the preceding days involved having a COVID19 test - no one can enter our hospitals without being tested first. I went with her, but watched from outside the door. She enjoyed that, and the doctor said she got an A+ for the way she took that thing in her nose and her throat.

    At the hospital today, no one allowed inside apart from the patient. She's been there before and I'd usually go with her to the room and through all the preparations until she's actually wheeled into the operating theater. Not so with COVID19 around. So they quite nicely asked me to go home and wait for a call. On my return they pushed her out to the car, instead of me going in to bring her out like previous times.

    Certainly the "new normal".

    I hate the new normal for stuff like this - I had a routine procedure done 2 weeks ago and I missed having my husband by my side...

    Good to know we're not alone, and I surely understand how you felt.
  • GaleHawkins
    GaleHawkins Posts: 8,159 Member
    ahoy_m8 wrote: »
    Terribly disturbing. Couldn't believe my eyes when saw potential for vaccine approval prior to trial completion. WTF.

    When billions of $$$ are at stake and Zero $$$ of legal liability risk what's the risk to push it out before any negative findings hit the nightly news?